242996 3 /11/2015 CITY OF CARMEL, INDIANA VENDOR: 178002
I ® ONE CIVIC SQUARE KROGER CO CHECK AMOUNT: $*******756.83*
?� CARMEL, INDIANA 46032 CENTRAL CUSTOMER CHARGES CHECK NUMBER: 242996
PO BOX 644467 CHECK DATE: 03/11/15
PITTSBURG PA 15264-4467
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4239039 A32257 496.77 GENERAL PROGRAM SUPPL
1096 4239039 A32257 260.06 GENERAL PROGRAM SUPPL
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Tear Along Perforation and Return Bottom Portion Page 1 of 2
TICKETS AMT TICKETS AMT Customer No: A32257
1314324792 $134.32 0115326975 ($1.20) Statement Date: 2/28/2015
1314324834 $122.75 0115327369 $2.99
1314325452 $84.00 0115328090 $32.42 Amount Due: $756.83
0115326713 $17.80 0115328091 ($0.26)
0115326974 $87.94 0115328265 $171.59 Amount Enclosed: N5 .3
ease I Ica ee s "'
I
ng paid y p aang a c ec ox in me corresponding DOX.it amount pan is Grerent,please
denote the amount
REMIT PAYMENT TO:
Central Customer Charges
PO Box 644467
Pittsburgh, PA 15264-4467
P.O.Box 1648 Customer No: A32257
Hutchinson,KS 67504-1648
RETURN SERVICE REQUESTED Statement Date: 2/28/2015
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Due Date: DUE UPON RECEIPT
Amount Due: $756.83
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PAULA SCHLEMMER
CARMEL CLAY PARKS&RECREATIO
1411 EAST 116TH STREET
CARMEL, IN 46032
&y. ;Gurrent , ,57.84 Dayt3 `85=112 Days" �;_ 1.13+-Days
$0.00 $0.00 $0.00 $0.00 $0.00
ACCOUNT BILLING
! �"'( TICKET'•' fi`P;O./REF# CARD# STQRE DATE�T,ICKET AMOUNT.- �
1314324792 061072 273 959 02/03/2015 $134.32
1314324834 063297 273 998 02/03/2015 $122.75
1314325452 232373 283 959 02/06/2015 $84.00
0115326713 171749 283 959 02/12/2015 $17.80
0115326974 256428 283 959 02/13/2015 $87.94
0115326975 283 959 02/13/2015 ($1.20)
0115327369 445772 273 959 02/16/2015 $2.99
0115328090 125333 283 998 02/19/2015 $32.42
0115328091 283 998 02/19/2015 ($0.26)
0115328265 174027 283 959 02/20/2015 $171.59
For questions or copies,please contact Kroger Accounts Receivable toll free at BBB-327-4911(Gammie ext.65563 or Sarah ext.61825)or by email(cammie.combs@kroger.com
or sarah.mueller@kroger.com).Please review your account promptly and advise if payments have been made.There will be a$5.00 fee for each ticket copy requested.
Please retain the top portion for your records Page 1 of 2
P.O.Box 1648 Customer No: A32257
Hutchinson,KS 67504-1648
RETURN SERVICE REQUESTED Statement Date: 2/28/2015
Due Date: DUE UPON RECEIPT
Amount Due: $756.83
ACCOUNT BILLING
.; ,f a. sn. ww 'DATE,TICKET AMOUN
k e
TICKET ,R ' P O:lREF# , CARD# STORE PROCESSED
✓. '-' a`iki ``�.9 r'=.d@' a�e'S, �tLi" ;-x+�-- _
0115329625 234670 283 959 02/27/2015 $104.48
For questions or copies,please contact Kroger Accounts Receivable toll free at 888-327-4911(Cammie ext.65563 or Sarah ext.61825)or by email(cammie.combs@kroger.com
or sarah.mueller@kroger.com).Please review your account promptly and advise if payments have been made.There will be a$5.00 fee for each ticket copy requested.
crane.
Please retain the top portion for your records
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service,where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
178002 Kroger- Central Customer Charges
P.O. Box 644467 Date Due
Pittsburgh, PA 15264-4467
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
2/28/15 A32257 General Program supplies $ 188.48
2/28/15 A32257 _ _ General.Program supplies $ 86.74
2/28/15 A32257 General Program supplies - $` - 17l.-59- --
2/28/15
71.-59- --
2/28/15 A32257 General Program supplies $ 49.96
2/28/15 A32257 General Program supplies $ 2.99
2/28/15 A32257 General Program supplies $ 257.07
I hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6 Total $ 756.83
, 20
Clerk-Treasurer
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Voucher No. Warrant No.
� Allowed
20
178002 Kroger- Central Customer Charges
P.O. Box 644467
Pittsburgh, PA 15264-4467 y In Sum of$
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$ 756.83
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ON ACCOUNT OF APPROPRIATION FOR 1:
108 ESE/109 Monon Center h
Board Members
PO#or INVOICE NO. ACCT#/TITL AMOUNT
Dept#
1081-4 A32257 4239039 $ 188.48 1 hereby certify that the attached invoice(s), or
1081-8 A32257 4239039 $ 86.74 1 bill(s)is(are)true and correct and that the
1081-9 A32257 4239039 $ 171.59 I; materials or services itemized thereon for
1081-11 A32257 4239039 $ 49.96 1 which charge is made were ordered and
1096-70 A32257 4239039 $ 2.99 received except
1096-60 A32257 4239039 $ 257.07
r
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March 5,2015
1'
Signature
$ 756.83 i Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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